Application-04/30/2014

How Did You Hear About Industry1one Staffing?( Required) *

Are you at least 18 years old?

Yes No

Are You Eligible to Work in the U.S.?

Yes No

Full Name *

First Name Middle Name Last Name Suffix

Telephone Number *

Mobile Number *

E-mail

Present Address(no P.O. Boxes accepted) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Do you have Transportation to and from work? *

Yes No

Best Time To Contact You? *

High School

College

City, State

Degree

Other Education/Trade School/

What shifts are you available to work? *

First Third Second All

Do you prefer: (temp to perm/temp/all) *

Temp To Perm Temporary All

What days are you available to work? *

Mon Tues Wed Thur Fri Sat Sun All

Assembly/Manf

Carpenter Helper

Sheet Metal Worker

Truck-Loading/Unloading

Banquet Help

Moving-General

Construction Clean-up

Drywall

Electrician Helper

Housekeeping

Forklift Driver-Certified

Office Furniture Assembly

Shipping/Receiveing

Clerical/Data Entry

Event Setup/Clean-up

Cook

Janitorial

Painter/Helper

Carpenter/Helper

Warehouse

Dishwashing

Food Prep

Landscaping

Plumber

Landscaping

Plumber Helaoer

Welder

From

To

Company Name

City, State

Supervisor

Phone Number

Job Duties

Reason For Leaving

From

To

Company Name

City, State

Supervisor

Phone Number

Job Duties

Reason For Leaving

Comments

UpLoad Resume or Other Information

I hereby declare that all statements contained in this application are true and correct and understand that false or inaccurate information in the application will be a basis for termination. I hereby authorize this company to investigate my background and verify this information. I understand that if employed, my employment will not be for any fixed period of time and may be terminated by the company at any time. I further understand that I am employed under a 90 day probationary period. I also authorize this company to release the information contained herein and its findings and work history of my employment to other firms or persons on request. I also understand and agree that I may be expected to work on a wide variety of job assignments at various pay levels depending on the assignment in the Greater Metropolitan Area and agree to accept such assignments for which I am qualified as they become available. I also understand my failure to report to the Industry1one office for work on the next workday at time of opening will indicate that I have refused work and that my unemployment benefits may be denied. I also agree to submit to drug and/or contagious disease screens upon request or as specified in company’s substance abuse policy. I agree to hold the Industry1one harmless and release it from any liability arising out of the process of verifying information soliciting employment references and providing information to Industry1one’s clients. I hereby authorize Industry1one to contact prior employers listed herein and I hereby agree not to sue and to release my prior employers from any damages or liability related to the release of information to Industry1one. I have read and understand all of the information provided to me in and with this application.

Personal Information

Education

Work Experience

Employement HIstory

Submit: Please Contact Industry1one Staffing to confirm reciept of your application